[Injury pattern in shoulder dislocation in the elderly patient].

PROBLEM: Recurrent shoulder dislocation is reported to be rare in older patients. While injuries of the glenoid labrum and the anterior capsule following primary dislocation in younger patients seem to determine the rate of instability, the pattern of damages in the elderly has rarely been studied.

METHODS

91 patients with an age older than 40 years with the diagnosis of primary (group A, n = 50) or recurrent (group B, n = 41) anterior shoulder dislocation were included in a prospective study. By analysis of the findings in x-rays, MRI, CT-scans and in 36 patients of diagnostic arthroscopy the pattern of intra- and periarticular pathology was evaluated.

RESULTS

While the incidence of bony Bankart- and Hill-Sachs lesions was constantly spread over the age groups the pattern of soft tissue damages was different. Up to the age of 60 years lesions of the glenoid labrum were leading while in older patients the prevalence of rotator cuff tears became about 70 percent.

CONCLUSIONS

The development of secondary osteoarthritis and persisting symptoms in older patients with rotator cuff tears after traumatic shoulder dislocation requires early diagnosis and appropriate treatment.